Universal Journal of Public Health Vol. 14(2), pp. 288 - 299
DOI: 10.13189/ujph.2026.140209
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Effectiveness of a Theory-Based Multi-Component School Nutrition Intervention on Overweight and Obesity in Rural Thai Children

Pornpana Somjit ^1,*, Natnapa Promma ¹, Kritsada Sarndhong ¹, Sarawut Sangkham ^2
1 Department of Community Health, School of Public Health, University of Phayao, Thailand
² Department of Environmental Health, School of Public Health, University of Phayao, Thailand

ABSTRACT

Childhood overweight and obesity represent major public health challenges in Thailand, particularly in rural areas experiencing rapid nutritional transitions. Schools provide an effective setting for the early establishment of healthy behaviors; however, evidence regarding theory-driven, multi-component interventions in resource-limited settings remains limited. This study evaluated a school-based nutrition promotion program grounded in the PRECEDE–PROCEED Model and Social Cognitive Theory, targeting overweight and obese primary school children in rural northern Thailand. A quasi-experimental pretest–posttest control group design was conducted from January to June 2025 in two public primary schools in Phayao Province. A total of 84 children aged 6–12 years were assigned to either an intervention group (n = 42) or a control group (n = 42). The 12-week intervention comprised healthy school lunch menu modification, interactive nutrition education, family and community reinforcement, and structured physical activity. Outcome measures—including weight-for-height Z-scores (WHZ), daily energy intake, dietary behaviors, and physical activity—were assessed at baseline, post-intervention, and three-month follow-up. ANCOVA and GEE analyses revealed significant reductions in daily energy intake (−128.3 vs. −28.6 kcal/day, p < 0.001) and improvements in dietary behaviors (+18.3 vs. +1.5 points, p < 0.001), which were sustained at follow-up. Physical activity levels increased significantly (p < 0.001). GEE models adjusted for age and sex indicated significantly reduced odds, corresponding to a 56–64% reduction in obesity risk in the intervention group (post-intervention: OR = 0.44; 95% CI: 0.21–0.94; follow-up: OR = 0.36; 95% CI: 0.16–0.82). This study demonstrates that a theory-driven, multi-component school-based intervention effectively improved dietary behaviors, physical activity, and nutritional status, offering a scalable model to guide obesity prevention policies in resource-limited settings.

KEYWORDS
Childhood Obesity, School-Based Intervention, Nutrition Promotion, Rural Health, Thailand, Social Cognitive Theory, PRECEDE-PROCEED Model

Cite This Paper in IEEE or APA Citation Styles
(a). IEEE Format:
[1] Pornpana Somjit , Natnapa Promma , Kritsada Sarndhong , Sarawut Sangkham , "Effectiveness of a Theory-Based Multi-Component School Nutrition Intervention on Overweight and Obesity in Rural Thai Children," Universal Journal of Public Health, Vol. 14, No. 2, pp. 288 - 299, 2026. DOI: 10.13189/ujph.2026.140209.

(b). APA Format:
Pornpana Somjit , Natnapa Promma , Kritsada Sarndhong , Sarawut Sangkham (2026). Effectiveness of a Theory-Based Multi-Component School Nutrition Intervention on Overweight and Obesity in Rural Thai Children. Universal Journal of Public Health, 14(2), 288 - 299. DOI: 10.13189/ujph.2026.140209.